Ultra-wide field imaging for ophthalmological evaluation of pregnant women with positive serology for toxoplasmosis

Abstract

ABSTRACT Objective To screen pregnant women with positive serological results for toxoplasmosis using non-invasive, ultra-wide field retinal imaging. Methods Prospective, descriptive longitudinal study including pregnant women with positive serological results for toxoplasmosis seen at three maternal care reference units located in Belém (PA), in the Brazilian Amazon. Patient data were collected via interview. Comprehensive eye examination, including best corrected visual acuity, biomicroscopy, tonometry and ultra-wide field imaging, was performed every three months. Results The sample comprised 36 pregnant women. Of these, 52% had a serological profile consistent with acute toxoplasmosis, whereas 48% had a serological profile consistent with immunity. Three pregnant women had signs of chorioretinitis on ultra-wide field imaging in the first trimester. An active lesion adjacent to a scarred lesion was detected in one patient. Only women with serological results consistent with acute toxoplasmosis were treated. Treatment with systemic corticosteroids was limited to the patient with active ocular lesion. Follow-up assessment revealed resolution of the ocular lesion and normalization of visual acuity (20/20). All newborns were examined. No signs of congenital toxoplasmosis were found. Conclusion Ophthalmological screening of pregnant women with positive serological results for toxoplasmosis should be standardized to prevent vision loss in newborns and mothers. Ultra-wide field retinal imaging can be used as an initial screening strategy to support referral for specialized care, particularly in areas with limited access ophthalmology services.

Keywords

• Chorioretinitis
• Ocular toxoplasmosis
• Pregnancy
• Diagnostic imaging
• Uveitis